Individual provider Active NPI

Jungyeon Leung, D.C.

  • Chiropractor
  • Flushing, NY
National Provider Identifier
1770815516
Registry record updated Jun 28, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
012089 Issued in NY
Practice address
4161 Kissena Blvd
Suite 22, Concourse Level
Flushing, NY 11355-3181
Phone
(516) 312-0901
NPI assigned
Feb 4, 2010
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 28, 2016

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 38MC00688700 NJ
Student in an Organized Health Care Education/Training Program 390200000X
Chiropractor 111N00000X 012089 NY Primary

Addresses

Primary practice location

4161 Kissena Blvd
Suite 22, Concourse Level
Flushing, NY 11355-3181

Mailing address

4161 Kissena Blvd
Ste 22
Flushing, NY 11355-3131
Phone (718) 359-0330

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20120307000298 NY Practitioner - Chiropractic 2264610948 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
New York Chiropractic College, 2010
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Tower Chiropractic Wellness P.CGroup PAC ID 3173781119, 2 clinicians

Practice addresses (Care Compare)

4161 Kissena Blvd
Suite 22
Flushing, NY 11355-3131
Phone (516) 312-0901

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Tower Chiropractic Wellness P.C Chiropractor CurrentSince Mar 1, 2012 Accepting new patients
Ospt of Clifton LLC Chiropractor PastSince Oct 13, 2024 Accepting new patients
Eickhoff Chiropractic Family Wellness Center Chiropractor PastSince May 1, 2005 Accepting new patients

Locations

4161 Kissena Blvd
Ste 22
Flushing, NY 11355
Phone (516) 312-0901

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1265241600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1467072000000",
    "number": "1770815516",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4161 KISSENA BLVD",
            "address_2": "STE 22",
            "city": "FLUSHING",
            "state": "NY",
            "postal_code": "113553131",
            "telephone_number": "718-359-0330"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4161 KISSENA BLVD",
            "address_2": "SUITE 22, CONCOURSE LEVEL",
            "city": "FLUSHING",
            "state": "NY",
            "postal_code": "113553181",
            "telephone_number": "516-312-0901"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LEUNG",
        "first_name": "JUNGYEON",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-02-04",
        "last_updated": "2016-06-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "NJ",
            "license": "38MC00688700",
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "NY",
            "license": "012089",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Flushing, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 28, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.